Departamento de Ciências da Vida, Universidade do Estado da Bahia, Rua Silveira Martins, 2555, Cabula41.150-000, Salvador, Bahia, Brazil.
Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil.
Arch Sex Behav. 2023 Feb;52(2):703-719. doi: 10.1007/s10508-022-02371-y. Epub 2022 Jul 25.
Using baseline data from the PrEP1519 cohort, in this article we aimed to analyze: (i) the effectiveness of demand creation strategies (DCS) to enroll adolescent men who have sex with men (AMSM) and adolescent transgender women (ATGW) into an HIV combination prevention study in Brazil; (ii) the predictors of DCS for adolescents' enrollment; and (iii) the factors associated with DCS by comparing online and face-to-face strategies for enrollment. The DCS included peer recruitment (i.e., online and face-to-face) and referrals from health services and non-governmental organizations (NGOs). AMSM and ATGW who agreed to participate in the study could opt to enroll in either PrEP (PrEP arm) or to use other prevention methods (non-PrEP arm). Bivariate and multivariate analyses were conducted and logistic regression odds ratios were estimated. The DCS reached 4529 AMSM and ATGW, the majority of which were derived online (73.8%). Of this total, 935 (20.6%) enrolled to participate (76.6% in PrEP arm and 23.4% in non-PrEP arm). The effectiveness of enrolling adolescents into both arms was greater via direct referrals (235/382 and 84/382, respectively) and face-to-face peer recruitment (139/670 and 35/670, respectively) than online (328/3342). We found that a combination under DCS was required for successful enrollment in PrEP, with online strategies majorly tending to enroll adolescents of a higher socioeconomic status. Our findings reinforce the need for DCS that actively reaches out to all adolescents at the greatest risk for HIV infection, irrespective of their socioeconomic status.
利用 PrEP1519 队列的基线数据,本文旨在分析:(i) 需求创造策略(DCS)在招募巴西青少年男男性行为者(AMSM)和青少年跨性别女性(ATGW)参与 HIV 综合预防研究中的有效性;(ii) 青少年入组的 DCS 预测因素;(iii) 通过比较线上和线下招募策略,分析与 DCS 相关的因素。DCS 包括同伴招募(即线上和线下)和卫生服务机构及非政府组织(NGO)的转介。同意参与研究的 AMSM 和 ATGW 可以选择参加 PrEP(PrEP 组)或使用其他预防方法(非 PrEP 组)。进行了单变量和多变量分析,并估计了逻辑回归比值比。DCS 覆盖了 4529 名 AMSM 和 ATGW,其中大部分是通过线上渠道招募的(73.8%)。在这一总数中,有 935 人(20.6%)报名参加(76.6%在 PrEP 组,23.4%在非 PrEP 组)。通过直接转介(分别为 235/382 和 84/382)和面对面的同伴招募(分别为 139/670 和 35/670),入组青少年到两个组的效果都大于线上招募(分别为 328/3342)。我们发现,需要通过 DCS 组合才能成功招募到 PrEP 参与者,线上策略主要倾向于招募社会经济地位较高的青少年。我们的研究结果强化了需要采取积极的 DCS,以接触到所有感染 HIV 风险最高的青少年,而不论其社会经济地位如何。
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